PulmCCM

NOVEMBER 17, 2023

Operating point guided resuscitation How do we make sense of this? The trick, I believe, lies in ‘operating point guided resuscitation’ [OPGR]. Put another way, because the OP is comprised of both P ra and CO/SV, both values are quantified or qualified at each step of resuscitation. Download his free textbook here.

Operations 132

Operations Ultrasounds Resuscitation Blood Transfusions 132

RebelEM

MAY 18, 2023

Background: IV fluids are part of the standard resuscitation bundle in septic shock, however it is unclear if they provide a significant benefit. Background: IV fluids are part of the standard resuscitation bundle in septic shock, however it is unclear if they provide a significant benefit. Liberal: 14.9% Liberal: 14.9% Liberal: 14.9%

Sepsis 105

Sepsis Shock Resuscitation Outcomes 105

PulmCCM

FEBRUARY 28, 2022

Further, the treating clinician must have deemed either normal saline or balanced crystalloid as appropriate resuscitation options; the patient’s expected-admission to the ICU must have been at least 3 days. saline crystalloid resuscitation, the inter-trial evaluations become murkier, though seemingly less tendentious.

Fluid Resuscitation 40

Fluid Resuscitation Resuscitation Outcomes Sepsis 40

RebelEM

JULY 17, 2023

Click here for Direct Download of the Podcast Paper: Knack SKS et al. It is possible that the induction agent used could play an important role on hemodynamic effects in critically ill adults. REBEL Cast Ep120: Etomidate vs Ketamine for RSI in the ED?

Outcomes 98

Outcomes Administration Emergency Department Resuscitation 98

Broome Docs

FEBRUARY 22, 2024

As is always the case – the papers we discuss are free to download by just clicking the links in the sections below… so don’t trust me, go read them for yourself! Should you replace fingernails on crushed digits? Should anybody be doing REBOA in 2024? Are topical anaesthetic drops safe for folk with eye abrasions?

Emergency Department 103

Emergency Department Psychiatric Resuscitation Wellness 103

EM SIM Cases

JUNE 11, 2024

He looks so unwell that he is placed into the resuscitation bay. Organophosphate poisoning Download Case courtesy of Frank Gaillard, Radiopaedia.org. Clinical Vignette A 60-year old farmer presents to the ED with a runny nose, vomiting and diarrhea. He feels short of breath and dizzy.

Poisoning 52

Poisoning PPE Academics Resuscitation 52

The Trauma Pro

AUGUST 18, 2023

You can download a copy by clicking here. The Broxton tool covers all the basics and includes some additional data points that cover activation criteria, TXA administration, and administration of uncrossmatched blood. Click here to check it out. The Australian tool is much more robust with more data points that make a lot of sense.

Administration 100

Administration Operations Hospitals Wellness 100

EM SIM Cases

DECEMBER 15, 2023

Sameer Sharif (Hamilton Health Sciences, Hamilton, Ontario) and Dr. Sophie Ramsden (Emergency Medicine Resident, McMaster University, Hamilton, Ontario) Why it Matters Major trauma patients sometimes decompensate after initial resuscitation. Download Case Here Crit Care 3- Spinal cord injury Download

Fractures 40

Fractures Resuscitation Academics Shock 40

RebelEM

AUGUST 7, 2023

This helps relieve agitation/pain while maintaining spontaneous breathing and airway reflexes allowing for adequate pre-oxygenation as well as facilitates other resuscitation interventions including IV access, vasopressors, fluids, etc. that would not be possible in an agitated/combative patient.

Head Injuries 98

Head Injuries Outcomes Airway Management Burns 98

EM SIM Cases

OCTOBER 19, 2022

DOWNLOAD CASE HERE bronchiolitis Download Source = [link] They were directed to go to the emergency department. The patient will progress through escalating respiratory support and eventually require intubation and transfer to higher level of care.

Pediatrics 52

Pediatrics Emergency Department EMS Resuscitation 52

EM SIM Cases

FEBRUARY 15, 2023

The resuscitation team is expected to recognize and manage myasthenic crisis with respiratory failure, with consideration for airway management with an anterior mediastinal mass. Download Case Here: Download Case Over the last 24 hours, she has developed progressive weakness and bulbar symptoms.

Airway Management 40

Airway Management Academics Resuscitation Hospitals 40

PHEM Cast

APRIL 10, 2016

It is worth noting, that with “Sepsis 3” many of these terms will become out-of-date – but validation work is required… The Rivers’ paper can be accessed here: [link] It was a single centre study which compared standard care with protocolised resuscitation packaged together as early goal-directed therapy (EGDT).

Sepsis 52

Sepsis Fluid Resuscitation Resuscitation Emergency Department 52

EM SIM Cases

SEPTEMBER 19, 2024

Boating Trauma Download [link] ECG Source = [link] Treatment includes tourniquet application to the limb and rapid blood product administration. Intubation for clinical course and pain management need to be addressed with disposition to the operating room.

Shock 52

Shock Emergency Nursing Administration Operations 52

EM SIM Cases

JULY 19, 2023

Asthma in Pregnancy Download Case courtesy of Henry Knipe, Radiopaedia.org. CASE SUMMARY A third trimester patient presents with a severe asthma exacerbation that deteriorates and requires BiPAP/ICU admission. The learner will need to identify severe asthma and manage accordingly accounting for differences in physiology during pregnancy.

OB/GYN 52

OB/GYN Resuscitation 52

EM SIM Cases

NOVEMBER 3, 2023

Heat Related Illness Download ECG Curtesy of Life in the Fast Lane, ECG Library for sinus tachycardia. CASE SUMMARY In this case of exertional heatstroke, the team must identify hyperthermia and actively cool the patient while working the patient up for other causes. Link can be found here.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia EKG/ECG EMS Hospitals 52

EM SIM Cases

JANUARY 10, 2023

DOWNLOAD CASE HERE GSW Vascular Injury Download For both junior and senior learners, the patient progresses from threatened limb (requiring emergent investigation) to a pulseless limb (requiring emergent OR). For senior learners, there will be an additional element of instability from the penetrating chest injury requiring chest tube.

Academics 40

Academics Emergency Department Hospitals Resuscitation 40

AED Leader

JUNE 15, 2024

The Philips HeartStart M5066A AED is designed with an intuitive interface that guides even untrained users through the resuscitation process. Rescuers can easily download and review event data, which can be shared with medical professionals to analyze and evaluate the rescue efforts.

CPR 52

CPR Shock Resuscitation 52

EM SIM Cases

MAY 9, 2023

Pediatric Drowning Download Hon, K. , The team should begin CPR and follow the PALS pediatric bradycardia algorithm. PICU should be called if not already involved. After one round of CPR, the patient’s heart rate will increase and the consulting team should arrive. Cheung, H. & & Cheung, K.

Pediatrics 52

Pediatrics CPR Radiology Radiology 52

PulmCCM

SEPTEMBER 9, 2021

Sylvia Plath Background Implicit in resuscitation is speed. Septic sheep randomized to early, rapid volume resuscitation had greater vasopressor requirements 12 hours after initial fluid bolus. The abovementioned ovine resuscitation study gave a fluid bolus at 40 mL/kg over 1 hour – a rate of 47 mL/min in a 70 kg adult.

Resuscitation 40

Resuscitation Fluid Resuscitation Sepsis Outcomes 40

ETM Course

JULY 9, 2015

And feel free to run your own trials and let us know if they’re similar or different! For more information on the various types of large bore IV access check out our post on large bore vascular access devices.

Shock 52

Shock Resuscitation 52

PulmCCM

MARCH 7, 2022

” -Joni Mitchell Background As remarked by the authors of the recent PLUS trial , a systematic review and meta-analysis of randomized controlled trials comparing balanced resuscitation fluid to 0.9% saline for resuscitation and/or maintenance therapy. Download his free textbook here.

Resuscitation 40

Resuscitation Outcomes Research 40

EM SIM Cases

AUGUST 17, 2023

lvad-pump-thrombosis Download The team will need to progress through the initial assessment of an LVAD patient, ultimately leading to a diagnosis of pump thrombosis. They will initiate anticoagulation, consult cardiothoracic surgery, and admit to CTICU.

Emergency Department 40

Emergency Department EMS Hospitals Resuscitation 40

RebelEM

JANUARY 25, 2023

CT is the most widely accepted imaging modality but US (both formal and ED) has better performance characteristics Patients with SBO should have an emergent surgical consultation and treatment should start with good supportive care (IV fluids, electrolyte repletion, antiemetics) Patients with hypotension, hypoperfusion or frank sepsis from an SBO should (..)

Operations 52

Operations Sepsis Resuscitation Ultrasounds 52

Downeast Emergency Medicine

APRIL 26, 2021

The primary outcome was 30-day mortality with secondary outcomes looking at 24 hour in-hospital mortality, blood resuscitation at 6 and 24 hours, incidence of multiorgan failure, ARDS, nosocomial infection, early seizures, PE/DVT, crystalloid resuscitation after 24 hours, and the incidence of coagulopathy. Arch Surg 2012; 147:113-119.[

Head Injuries 52

Head Injuries Administration Outcomes Seizures 52

American Medical Compliance

FEBRUARY 15, 2023

The courses include module quizzes, downloadable materials, individual support, and questions for test preparation. When you look for such courses, look for topics such as first aid, personal care, and resuscitation techniques. The specific requirements for the training, mechanics, and composition of the training vary in every state.

Administration 52

Administration Infectious Diseases Operations Best Practices 52

American Medical Compliance

FEBRUARY 15, 2023

The courses include module quizzes, downloadable materials, individual support, and questions for test preparation. When you look for such courses, look for topics such as first aid, personal care, and resuscitation techniques. The specific requirements for the training, mechanics, and composition of the training vary in every state.

EMS 52

EMS Administration Infectious Diseases Operations 52

Taming the SRU

MAY 30, 2023

The AirRx app contains information regarding common medications and equipment available, top diagnoses, medicolegal information and more, and is available to download for free. Legal implications vary from country to country. Some airlines may carry more than what is required.

OB/GYN 52

OB/GYN Ultrasounds Pediatrics Resuscitation 52

PulmCCM

JANUARY 4, 2022

Thoughts Barthelemy and colleagues report an inventive and necessary study for those interested in resuscitation physiology. Download his free textbook here. These values corresponded with weight-adjusted volumes of 3 mL/kg, 2.0 mL/kg and 4.2 mL/kg, respectively.

Wellness 40

Wellness Outcomes Sepsis Stroke 40

Don't Forget the Bubbles

AUGUST 13, 2023

You are called to the resuscitation bay in your ED following arrival of the expected pediatric alert. It is a 13-month-old female child with a history of two episodes of generalised clonic tonic seizures at home lasting for 3-5 mins, around 90 mins before presentation in the ED.

Seizures 97

Seizures Pediatrics Dehydration Radiology 97

Rural Doctors Net

AUGUST 30, 2013

Imagine being able to stream or access a downloaded 60 sec video file on how to perform a critical procedure – not a tool for novices, but a useful aide memoire for rural clinicians who may only do this stuff once in a blue moon. Remember “the best clot is the one you’ve got” – don’t dislodge it! Emlyns on the PROMMT data.

Burns 52

Burns Hospitals Wellness Ambulance Services 52

RebelEM

JUNE 12, 2024

REBEL Core Cast 124.0 – Hyperinsulinemia Euglycemia Therapy Click here for Direct Download of the Podcast. Patients often succumb to volume overload given pre-existing cardiac disease and the volume of medical resuscitation through their hospital stay. Ask pharmacy to concentrate insulin from 1 unit/mL to 10 units/ml.

Poisoning 105

Poisoning Stroke Shock Administration 105

Broome Docs

OCTOBER 28, 2023

As always – the free PDFs are linked to the titles, and you can download the audio via podcast apps or stream from the link below. Family presence during cardiopulmonary resuscitation. Fitzpatrick, S. Straight from the Crocodile’s Mouth. 1326-5377.2010.tb04119.x JAMA Intern Med. 2023 Aug 1;183(8):818-823. N Engl J Med.

Ultrasounds 67

Ultrasounds Resuscitation 67

RebelEM

MAY 15, 2024

REBEL Core Cast 122.0 – Neutropenic Fever Click here for Direct Download of the Podcast. Identify low risk patients and send them home with PO antibiotics and close oncology follow-up in conjunction with your oncologist. Give appropriate fluids, vasopressors, and antibiotics.

Infectious Diseases 104

Infectious Diseases Administration Sepsis Anaphylaxis 104

EM SIM Cases

AUGUST 23, 2022

Once the resuscitation begins, the mildly confused patient comments on the resident’s appearance “lucky me to get such a good-looking doctor” (gender stereotype 2). As the case progresses, she will encounter multiple gendered microaggressions. Once the patient is more settled, he asks the resident for warm blankets and ginger ale.

Operations 40

Operations Resuscitation Wellness Hospitals 40

RebelEM

DECEMBER 19, 2022

REBEL Cast Ep113 – Defibrillation Strategies for Refractory Ventricular Fibrillation Click here for Direct Download of the Podcast Paper: Cheskes S, et al. With everything just mentioned considered, DED, in addition to other resuscitative therapies, should still be used for patients in RVF. N Engl J Med. N Engl J Med.

EMS 52

EMS CPR Shock Resuscitation 52

PulmCCM

MARCH 1, 2022

General topics include: sepsis, resuscitation, COVID and ventilation, advanced hemodynamics, advanced POCUS, with spotlights on nephrology, general surgery, POCUS for hospitalists and lots else. Download his free textbook here. But this year offers much more than POCUS!

Ultrasounds 40

Ultrasounds Resuscitation Sepsis 40